Abstract
Peribulbar and retrobulbar anaesthesia are commonly used techniques in cataract extraction. They offer satisfactory analgesia and akinesia but serious complications although uncommon are consistently reported. Intravenous sedation combined with a facial nerve block offers an alternative method of anaesthesia. This is a retrospective study of patients who underwent extracapsular cataract extraction using this technique between 1 January 1986 and 1 September 1990. The operating conditions were judged to be very suitable with minimal peroperative complications. The postoperative ocular complication rate was low (minimum follow-up 3 months) and no serious medical complications were noted: 93.8% of patients achieved 6/12 vision or better. This study demonstrates that it is possible to achieve satisfactory ocular analgesia and akinesia during cataract extraction under local anaesthesia without the use of a periocular injection.
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Selected References
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- Ahn J. C., Stanley J. A. Subarachnoid injection as a complication of retrobulbar anesthesia. Am J Ophthalmol. 1987 Feb 15;103(2):225–230. doi: 10.1016/s0002-9394(14)74232-1. [DOI] [PubMed] [Google Scholar]
- Allen A. W., Zhang H. R. Extracapsular cataract extraction: prognosis and complications with and without posterior-chamber lens implantations. Ann Ophthalmol. 1987 Sep;19(9):329–333. [PubMed] [Google Scholar]
- Brookshire G. L., Gleitsmann K. Y., Schenk E. C. Life-threatening complication of retrobulbar block. A hypothesis. Ophthalmology. 1986 Nov;93(11):1476–1478. doi: 10.1016/s0161-6420(86)33543-7. [DOI] [PubMed] [Google Scholar]
- Coonan P., Fung W. E., Webster R. G., Jr, Allen A. W., Jr, Abbott R. L. The incidence of retinal detachment following extracapsular cataract extraction. A ten-year study. Ophthalmology. 1985 Aug;92(8):1096–1101. doi: 10.1016/s0161-6420(85)33899-x. [DOI] [PubMed] [Google Scholar]
- Hamilton R. C., Gimbel H. V., Strunin L. Regional anaesthesia for 12,000 cataract extraction and intraocular lens implantation procedures. Can J Anaesth. 1988 Nov;35(6):615–623. doi: 10.1007/BF03020350. [DOI] [PubMed] [Google Scholar]
- Hosking M. P., Lobdell C. M., Warner M. A., Offord K. P., Melton L. J., 3rd Anaesthesia for patients over 90 years of age. Outcomes after regional and general anaesthetic techniques for two common surgical procedures. Anaesthesia. 1989 Feb;44(2):142–147. doi: 10.1111/j.1365-2044.1989.tb11166.x. [DOI] [PubMed] [Google Scholar]
- Kimble J. A., Morris R. E., Witherspoon C. D., Feist R. M. Globe perforation from peribulbar injection. Arch Ophthalmol. 1987 Jun;105(6):749–749. doi: 10.1001/archopht.1987.01060060035017. [DOI] [PubMed] [Google Scholar]
- Klein M. L., Jampol L. M., Condon P. I., Rice T. A., Serjeant G. R. Central retinal artery occlusion without retrobulbar hemorrhage after retrobulbar anesthesia. Am J Ophthalmol. 1982 May;93(5):573–577. doi: 10.1016/s0002-9394(14)77371-4. [DOI] [PubMed] [Google Scholar]
- Morgan C. M., Schatz H., Vine A. K., Cantrill H. L., Davidorf F. H., Gitter K. A., Rudich R. Ocular complications associated with retrobulbar injections. Ophthalmology. 1988 May;95(5):660–665. doi: 10.1016/s0161-6420(88)33130-1. [DOI] [PubMed] [Google Scholar]
- Pautler S. E., Grizzard W. S., Thompson L. N., Wing G. L. Blindness from retrobulbar injection into the optic nerve. Ophthalmic Surg. 1986 Jun;17(6):334–337. [PubMed] [Google Scholar]
- Percival S. P. Long term complications from extracapsular cataract surgery. Trans Ophthalmol Soc U K. 1985;104(Pt 8):915–918. [PubMed] [Google Scholar]
- Ramsay R. C., Knobloch W. H. Ocular perforation following retrobulbar anesthesia for retinal detachment surgery. Am J Ophthalmol. 1978 Jul;86(1):61–64. doi: 10.1016/0002-9394(78)90016-8. [DOI] [PubMed] [Google Scholar]
- Rassam S., Thomas H. F. Local anaesthesia for cataract surgery. Lancet. 1989 Jan 14;1(8629):110–111. doi: 10.1016/s0140-6736(89)91475-x. [DOI] [PubMed] [Google Scholar]
- Redmond R. M., Dallas N. L. Extracapsular cataract extraction under local anaesthesia without retrobulbar injection. Br J Ophthalmol. 1990 Apr;74(4):203–204. doi: 10.1136/bjo.74.4.203. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Roper-Hall M. J. Rayner lecture 1984. Sophistication in intraocular lens surgery. Trans Ophthalmol Soc U K. 1985;104(Pt 5):500–506. [PubMed] [Google Scholar]
- Smith R. Cataract extraction without retrobulbar anaesthetic injection. Br J Ophthalmol. 1990 Apr;74(4):205–207. doi: 10.1136/bjo.74.4.205. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stallard S., Prescott S. Postoperative urinary retention in general surgical patients. Br J Surg. 1988 Nov;75(11):1141–1143. doi: 10.1002/bjs.1800751128. [DOI] [PubMed] [Google Scholar]
- Weiss J. L., Deichman C. B. A comparison of retrobulbar and periocular anesthesia for cataract surgery. Arch Ophthalmol. 1989 Jan;107(1):96–98. doi: 10.1001/archopht.1989.01070010098035. [DOI] [PubMed] [Google Scholar]
- Whitsett J. C., Balyeat H. D., McClure B. Comparison of one-injection-site peribulbar anesthesia and retrobulbar anesthesia. J Cataract Refract Surg. 1990 Mar;16(2):243–245. doi: 10.1016/s0886-3350(13)80738-9. [DOI] [PubMed] [Google Scholar]
- Wilhelmus K. R., Emery J. M. Posterior capsule opacification following phacoemulsification. Ophthalmic Surg. 1980 Apr;11(4):264–267. [PubMed] [Google Scholar]